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Osteoporosis: Should I Take Bisphosphonate Medicines?

You may want to have a say in this decision, or you may simply want to follow your doctor's recommendation. Either way, this information will help you understand what your choices are so that you can talk to your doctor about them.

Osteoporosis: Should I Take Bisphosphonate Medicines?

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QuizYourself

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Your Summary

Get the facts

Your options

Take bisphosphonate medicines to lower the risk of bone
fractures.

Don't take medicines. Try healthy habits to lower your
risk.

Key points to remember

If you have osteoporosis, bisphosphonate
medicines can increase bone thickness and lower your risk of spine and hip
fractures. You may also want to think about taking
them if you have
osteopenia or
risk factors for osteoporosis. Some of the risk factors are smoking, getting little or no exercise, having a family history of osteoporosis, having certain medical conditions, and taking certain medicines. Talk with your doctor if you're not sure what your risk is.

Bisphosphonates can have side effects, such as heartburn, belly
pain, and headaches. These medicines have been in use for many years. But
their long-term effects are not known.

Whether you take medicine
or not,
healthy habits can also help protect your bones. Take
calcium and vitamin D supplements. Get regular weight-bearing exercise, and cut
back on alcohol. If you smoke, quit.

If you start taking
bisphosphonates and have problems with side effects, you can try other
medicines. Talk with your doctor.

Osteoporosis is a disease
that affects your
bones. It means you have bones that are thin and
brittle, with lots of holes inside them like a sponge. This makes them easy to
break. It also increases your risk for spine and hip
fractures. These fractures can be disabling and make
it hard for you to live on your own.

Your bones naturally get
thinner as you age, making them more likely to break. But whether you take
medicine or not,
healthy habits can protect your bones and prevent bone
loss. Take calcium and vitamin D supplements. Get regular weight-bearing
exercise, and cut back on alcohol. If you smoke, quit.

Bisphosphonates are
the most common medicines used to prevent bone loss in people who have
osteoporosis. They slow the way bone dissolves and is absorbed by your body.
They can increase bone thickness and strength.

They
include:

Alendronate (Fosamax).

Ibandronate
(Boniva).

Risedronate (Actonel or Atelvia).

Zoledronic acid
(Reclast).

Bisphosphonates aren't right for everyone. Depending on
your health, your doctor may suggest other medicines to help prevent bone loss.
Your doctor may also suggest these other medicines if you are having a problem
with side effects from bisphosphonates.

Other medicines
include:

Calcitonin (Fortical or Miacalcin).

Denosumab (Prolia).

Hormone therapy (HT) or
estrogen therapy (ET).

Raloxifene (Evista).

Teriparatide (Forteo).

Women who have gone through menopause can take
bisphosphonates instead of hormone therapy for osteoporosis. But
bisphosphonates won't help with
menopause symptoms.

Most of these medicines should be taken in the morning with a full glass of water at least 30 minutes before eating a meal, drinking a beverage, or taking any other medicine. If your doctor prescribes the form of risedronate called Atelvia, take it right after breakfast with a glass of water.

Zoledronic acid is
injected into a vein in your arm. Most people who use
it get just one dose each year. One form of ibandronate is also given in a
vein, usually every 3 months.

If you have osteoporosis, you
should also take calcium and vitamin D supplements. Take them at least 2 hours
before or after you take these medicines.

If
you take the medicines as prescribed, side effects are not common. But they can
include:

Heartburn and irritation of the tube that connects the throat to the stomach (esophagus), if you are taking bisphosphonate pills. These side effects can usually be avoided by following the instructions for taking your medicine.

Headache; constipation, diarrhea, and passing gas; and muscle and joint pain, if you are taking intravenous (IV) bisphosphonate shots.

Allergic reactions.

If you start taking these medicines and have problems
with side effects, you can try other medicines. Talk with your doctor.

Your doctor may want you to have a follow-up bone density test after you have been on treatment. If this is suggested for you, it will be done no more than every 2 years. Getting follow-up tests doesn't make your treatment work better.

Compare your options

You take
bisphosphonate pills on a schedule that could be once
a day, once a week, or once a month. Or you may get a shot in a vein in your
arm once a year.

You take calcium and vitamin D supplements.

These medicines can help
increase bone thickness and strength. This reduces your risk of hip and spine
fractures.

The long-term
effects of these medicines are not known. It is not clear how long you should take bisphosphonates.

Side effects are not
common but can include:

Heartburn, belly pain, and irritation of
the
esophagus (the tube that connects the throat to the stomach).

Headache and pain in muscles
and joints.

Constipation, diarrhea, and passing gas.

Trouble swallowing.

Allergic reactions.

Don't take
bisphosphonates Don't take
bisphosphonates

You take calcium and
vitamin D supplements.

You adopt
healthy habits such as getting regular weight-bearing
exercise, eating a healthy diet, limiting alcohol, and not
smoking.

You try other medicines such as:

Calcitonin (Calcimar or Miacalcin).

Denosumab (Prolia).

Hormone therapy (HT) or
estrogen therapy (ET).

Raloxifene (Evista).

Teriparatide (Forteo).

You may be able to
reduce your risk of fractures.

You avoid the cost of medicine, unless you take another kind such
as raloxifene.

You avoid the side effects of these
medicines.

If your
bones are very thin and brittle, you may be at risk for fractures.

Personal stories about taking bisphosphonate medicines

These stories are based on information gathered from health professionals and consumers. They may be helpful as you make important health decisions.

I was taking
hormone therapy for osteoporosis but decided to quit after reading about the
risks. I decided to try bisphosphonate medicines to protect against
osteoporosis. I have small bones like my mother, and she suffered terribly in
her old age from a collapsed spine.

Clarissa, age 60

I have
terrible hot flashes. Taking hormones has saved my sanity. I guess I'll
continue to take them for a few more years. In the meantime, my doctor tells me
that I won't need to take other medicines to prevent osteoporosis.

Joy, age
49

I broke my hip when I fell in the bathroom.
My doctor says I have osteoporosis and that I should take medicine to prevent
more broken bones. I guess I better take it.

What else do you need to make your decision?

NoSorry, that's not right. Bisphosphonates increase bone thickness and strength and can lower your risk of spine and hip fractures.

I'm not sureIt may help to go back and read "Get the Facts." Bisphosphonates increase bone thickness and strength and can lower your risk of spine and hip fractures.

2.

Can healthy habits also help protect your bones?

YesYou're right. Whether you take medicine or not, healthy habits can also help protect your bones. Try taking calcium and vitamin D supplements. Get regular weight-bearing exercise, cut back on alcohol, and quit smoking.

NoSorry, that's not right. Whether you take medicine or not, healthy habits can also help protect your bones. Try taking calcium and vitamin D supplements. Get regular weight-bearing exercise, cut back on alcohol, and quit smoking.

I'm not sureIt may help to go back and read "Get the Facts." Whether you take medicine or not, healthy habits can also help protect your bones.

3.

Are bisphosphonates the only medicines you can take for osteoporosis?

YesSorry, that's not right. Talk with your doctor about other medicines you might try besides bisphosphonates, especially if you have problems with side effects.

NoYou're right. Talk with your doctor about other medicines you might try besides bisphosphonates, especially if you have problems with side effects.

I'm not sureIt may help to go back and read "Get the Facts." You can talk with your doctor about other medicines you might try besides bisphosphonates, especially if you have problems with side effects.

You may want to have a say in this decision, or you may simply want to follow your doctor's recommendation. Either way, this information will help you understand what your choices are so that you can talk to your doctor about them.

Osteoporosis: Should I Take Bisphosphonate Medicines?

Here's a record of your answers. You can use it to talk with your doctor or loved ones about your decision.

Get the facts

Compare your options

What matters most to you?

Where are you leaning now?

What else do you need to make your decision?

1. Get the Facts

Your options

Take bisphosphonate medicines to lower the risk of bone
fractures.

Don't take medicines. Try healthy habits to lower your
risk.

Key points to remember

If you have osteoporosis, bisphosphonate
medicines can increase bone thickness and lower your risk of spine and hip
fractures. You may also want to think about taking
them if you have
osteopenia or
risk factors for osteoporosis. Some of the risk factors are smoking, getting little or no exercise, having a family history of osteoporosis, having certain medical conditions, and taking certain medicines. Talk with your doctor if you're not sure what your risk is.

Bisphosphonates can have side effects, such as heartburn, belly
pain, and headaches. These medicines have been in use for many years. But
their long-term effects are not known.

Whether you take medicine
or not,
healthy habits can also help protect your bones. Take
calcium and vitamin D supplements. Get regular weight-bearing exercise, and cut
back on alcohol. If you smoke, quit.

If you start taking
bisphosphonates and have problems with side effects, you can try other
medicines. Talk with your doctor.

FAQs

What is osteoporosis?

Osteoporosis is a disease
that affects your
bones. It means you have bones that are thin and
brittle, with lots of holes inside them like a sponge. This makes them easy to
break. It also increases your risk for spine and hip
fractures. These fractures can be disabling and make
it hard for you to live on your own.

Your bones naturally get
thinner as you age, making them more likely to break. But whether you take
medicine or not,
healthy habits can protect your bones and prevent bone
loss. Take calcium and vitamin D supplements. Get regular weight-bearing
exercise, and cut back on alcohol. If you smoke, quit.

What are bisphosphonates?

Bisphosphonates are
the most common medicines used to prevent bone loss in people who have
osteoporosis. They slow the way bone dissolves and is absorbed by your body.
They can increase bone thickness and strength.

They
include:

Alendronate (Fosamax).

Ibandronate
(Boniva).

Risedronate (Actonel or Atelvia).

Zoledronic acid
(Reclast).

Bisphosphonates aren't right for everyone. Depending on
your health, your doctor may suggest other medicines to help prevent bone loss.
Your doctor may also suggest these other medicines if you are having a problem
with side effects from bisphosphonates.

Other medicines
include:

Calcitonin (Fortical or Miacalcin).

Denosumab (Prolia).

Hormone therapy (HT) or
estrogen therapy (ET).

Raloxifene (Evista).

Teriparatide (Forteo).

Women who have gone through menopause can take
bisphosphonates instead of hormone therapy for osteoporosis. But
bisphosphonates won't help with
menopause symptoms.

What are the benefits of these medicines?

Studies show that bisphosphonates increase bone thickness and lower your risk of fractures.1

How are they taken?

Most of these medicines should be taken in the morning with a full glass of water at least 30 minutes before eating a meal, drinking a beverage, or taking any other medicine. If your doctor prescribes the form of risedronate called Atelvia, take it right after breakfast with a glass of water.

Zoledronic acid is
injected into a vein in your arm. Most people who use
it get just one dose each year. One form of ibandronate is also given in a
vein, usually every 3 months.

If you have osteoporosis, you
should also take calcium and vitamin D supplements. Take them at least 2 hours
before or after you take these medicines.

What are the side effects of these medicines?

If
you take the medicines as prescribed, side effects are not common. But they can
include:

Heartburn and irritation of the tube that connects the throat to the stomach (esophagus), if you are taking bisphosphonate pills. These side effects can usually be avoided by following the instructions for taking your medicine.

Headache; constipation, diarrhea, and passing gas; and muscle and joint pain, if you are taking intravenous (IV) bisphosphonate shots.

Allergic reactions.

If you start taking these medicines and have problems
with side effects, you can try other medicines. Talk with your doctor.

Your doctor may want you to have a follow-up bone density test after you have been on treatment. If this is suggested for you, it will be done no more than every 2 years. Getting follow-up tests doesn't make your treatment work better.

2. Compare your options

You take
bisphosphonate pills on a schedule that could be once
a day, once a week, or once a month. Or you may get a shot in a vein in your
arm once a year.

You take calcium and vitamin D supplements.

You take calcium and
vitamin D supplements.

You adopt
healthy habits such as getting regular weight-bearing
exercise, eating a healthy diet, limiting alcohol, and not
smoking.

You try other medicines such as:

Calcitonin (Calcimar or Miacalcin).

Denosumab (Prolia).

Hormone therapy (HT) or
estrogen therapy (ET).

Raloxifene (Evista).

Teriparatide (Forteo).

What are the benefits?

These medicines can help
increase bone thickness and strength. This reduces your risk of hip and spine
fractures.

You may be able to
reduce your risk of fractures.

You avoid the cost of medicine, unless you take another kind such
as raloxifene.

You avoid the side effects of these
medicines.

What are the risks and side effects?

The long-term
effects of these medicines are not known. It is not clear how long you should take bisphosphonates.

Side effects are not
common but can include:

Heartburn, belly pain, and irritation of
the
esophagus (the tube that connects the throat to the stomach).

Headache and pain in muscles
and joints.

Constipation, diarrhea, and passing gas.

Trouble swallowing.

Allergic reactions.

If your
bones are very thin and brittle, you may be at risk for fractures.

Personal stories

Are you interested in what others decided to do? Many people have faced this decision. These
personal stories
may help you decide.

Personal stories about taking bisphosphonate medicines

These stories are based on information gathered from health professionals and consumers. They may be helpful as you make important health decisions.

"I was taking hormone therapy for osteoporosis but decided to quit after reading about the risks. I decided to try bisphosphonate medicines to protect against osteoporosis. I have small bones like my mother, and she suffered terribly in her old age from a collapsed spine."

— Clarissa, age 60

"I have terrible hot flashes. Taking hormones has saved my sanity. I guess I'll continue to take them for a few more years. In the meantime, my doctor tells me that I won't need to take other medicines to prevent osteoporosis."

— Joy, age
49

"I broke my hip when I fell in the bathroom. My doctor says I have osteoporosis and that I should take medicine to prevent more broken bones. I guess I better take it."

You're right. Whether you take medicine or not, healthy habits can also help protect your bones. Try taking calcium and vitamin D supplements. Get regular weight-bearing exercise, cut back on alcohol, and quit smoking.

3.
Are bisphosphonates the only medicines you can take for osteoporosis?

Yes

No

I'm not sure

You're right. Talk with your doctor about other medicines you might try besides bisphosphonates, especially if you have problems with side effects.

Decide what's next

1.
Do you understand the options available to you?

Yes

No

2.
Are you clear about which benefits and side effects matter most to you?

Yes

No

3.
Do you have enough support and advice from others to make a choice?

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